ASYMMETRICAL ELECTRODES FOR BIPOLAR VESSEL SEALING

Abstract

Bipolar electrosurgical instrument having a first and a second opposing jaw member at a distal end thereof, wherein each jaw member includes an outer housing, and an inner tissue engaging surface corresponding to the inner tissue engaging surface of the opposing jaw. The instruments includes the ability to move the jaw members relative to one another from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members cooperate to grasp tissue. The jaws include asymmetrical electrodes disposed on the inner tissue engaging surfaces. A first contact region of the electrode has a greater surface area than that of the second contact region. During resection procedures wider electrodes impart improved sealing energy to the patient-side vessel while providing sufficient energy to resected tissue to effect hemostasis.

Claims

1. An electrosurgical instrument, comprising: a first jaw member and a second opposing jaw member at a distal end of the electrosurgical instrument, wherein each jaw member includes an outer housing, and an inner tissue engaging surface; at least one of the jaw members movable from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members cooperate to grasp tissue therebetween; and an electrode disposed on the inner tissue engaging surface of at least one of the jaw members having a first contact region disposed adjacent to a first edge of the inner tissue engaging surface and a second contact region disposed adjacent to a second edge of the inner tissue engaging surface, wherein the surface area of the first contact region is greater than the surface area of the second contact region.

2. The electrosurgical instrument according to claim 1, wherein the ratio of the surface area of the first contact region to the surface area of the second contact region is about 3:1.

3. The electrosurgical instrument according to claim 1, wherein the ratio of the surface area of the first contact region to the surface area of the second contact region is in a range of about 1.2:1 to about 10:1.

4. The electrosurgical instrument according to claim 1, further comprising a rotating assembly for rotating the jaw members about a longitudinal axis of the electrosurgical instrument.

5. The electrosurgical instrument according to claim 1, wherein the ratio of the width of the first contact region to the surface area of the second contact region is in a range of about 1.2:1 to about 10:1.

6. The electrosurgical instrument according to claim 1, wherein the electrode is configured to electrically couple with a source of electrosurgical energy.

7. The electrosurgical instrument according to claim 1, further comprising a visual indicator disposed on the outer housing, wherein the visual indicator indicates a position of the first contact region or the second contact region.

8. The electrosurgical instrument according to claim 1, further comprising: a knife channel defined longitudinally along the inner tissue engaging surface of the jaws; a knife having a distal cutting edge and configured to traverse between a first position where the cutting edge is positioned proximally of the knife channel and a second position where the cutting edge is positioned at a distal end of the knife channel.

9. The electrosurgical instrument according to claim 8, wherein the knife is configured to electrically couple with a source of electrosurgical energy.

10. An electrosurgical instrument, comprising: a pair of opposing jaw members at a distal end of the electrosurgical instrument, wherein each jaw member includes an outer housing, and an inner tissue engaging surface corresponding to the inner tissue engaging surface of the opposing jaw; at least one jaw member being movable relative to the other jaw member from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members cooperate to grasp tissue therebetween; a first electrode disposed on an inner tissue engaging surface and disposed adjacent to a first edge of the inner tissue engaging surface; and a second electrode disposed on an inner tissue engaging surface and disposed adjacent to a second edge of the inner tissue engaging surface, wherein the width of the first electrode is greater than the width of the second electrode.

11. The electrosurgical instrument according to claim 10, wherein the ratio of the width of the first electrode to the width of the second electrode is about 3:1.

12. The electrosurgical instrument according to claim 10, wherein the ratio of the width of the first electrode to the width of the second electrode is in a range of about 1.2:1 to about 10:1.

13. The electrosurgical instrument according to claim 10, further comprising a rotating assembly for rotating the jaw members about a longitudinal axis of the electrosurgical instrument.

14. The electrosurgical instrument according to claim 10, wherein at least one of the first electrode or the second electrode is configured to electrically couple with a source of electrosurgical energy.

15. The electrosurgical instrument according to claim 10, further comprising a visual indicator disposed on the outer housing, wherein the visual indicator indicates a position of at least one of the first electrode or the second electrode.

16. The electrosurgical instrument according to claim 10, further comprising: a knife channel defined longitudinally in the inner tissue engaging surface of the jaws; a knife having a distal cutting edge and configured to traverse between a first position where the cutting edge is positioned proximally of the knife channel and a second position where the cutting edge is positioned at a distal end of the knife channel.

17. The electrosurgical instrument according to claim 16, wherein the knife is configured to electrically couple with a source of electrosurgical energy.

18. A method of treating a vessel, comprising the steps of: providing an instrument having a first opposing jaw member and a second opposing jaw member, wherein each opposing jaw member includes a first opposing contact region and a second opposing contact region, the first opposing contact region having a surface area greater than the surface area of the second opposing contact region; positioning the vessel between the jaws, wherein the first opposing contact regions are disposed over a first portion of the vessel and the second opposing contact regions are disposed over a second portion of the vessel closing the jaws to grasp the vessel therebetween; applying electrosurgical energy to the vessel via the first electrode and the second electrode to effect a seal in the first portion of the vessel and to effect hemostasis in the second portion of the vessel.

19. The method of treating a vessel according to claim 18, wherein a positive electrosurgical polarity is applied to the vessel by the first contact region and a negative electrosurgical polarity is applied to the vessel by the second contact region.

20. The method of treating a vessel according to claim 18, further comprising dividing the vessel using a knife coupled to a source of electrosurgical energy, wherein a negative electrosurgical polarity is applied to the vessel by the first contact region and the second contact region, and a positive electrosurgical polarity is applied to the vessel by the knife.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0018] Various embodiments of the subject instrument are described herein with reference to the drawings wherein:

[0019] FIG. 1 is a left, perspective view of an embodiment of a bipolar electrosurgical instrument in accordance with the present disclosure showing a housing, a shaft and a jaw assembly having an asymmetrical electrode;

[0020] FIG. 2 is an enlarged, left perspective view of an embodiment of a jaw assembly having an asymmetrical electrode in accordance with the present disclosure;

[0021] FIG. 3 is an enlarged, partially-exploded view of the FIG. 2 embodiment of a jaw assembly having an asymmetrical electrode in accordance with the present disclosure;

[0022] FIG. 4 is an enlarged, left perspective view of another embodiment of a jaw assembly having an asymmetrical electrode in accordance with the present disclosure;

[0023] FIG. 5 is an enlarged, partially-exploded view of the FIG. 4 embodiment of a jaw assembly having an asymmetrical electrode in accordance with the present disclosure;

[0024] FIG. 6A is an enlarged, cross-sectional view of the distal end of a jaw assembly in accordance with the present disclosure showing a knife assembly in a proximal position prior to the actuation thereof;

[0025] FIG. 6B is an enlarged, cross-sectional view of the distal end of a jaw assembly in accordance with the present disclosure showing a knife assembly in a distal position subsequent to the actuation thereof; and

[0026] FIG. 7 is a perspective view of another embodiment of a bipolar electrosurgical instrument in accordance with the present disclosure having a jaw assembly that includes an asymmetrical electrode.

DETAILED DESCRIPTION

[0027] Particular embodiments of the present disclosure are described hereinbelow with reference to the accompanying drawings, however, it is to be understood that the disclosed embodiments are merely examples of the disclosure, which may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure.

[0028] In the drawings and in the descriptions that follow, the term proximal, as is traditional, shall refer to the end of the instrument that is closer to the user, while the term distal shall refer to the end that is farther from the user. Similar reference numbers are used for elements that are the same or similar to elements illustrated or described herein. In addition, as used herein, terms referencing orientation, e.g., top, bottom, up, down, left, right, clockwise, counterclockwise, upper, lower, and the like, are used for illustrative purposes with reference to the figures and features shown therein. It is to be understood that embodiments in accordance with the present disclosure may be practiced in any orientation without limitation.

[0029] Referring to FIG. 1, a bipolar surgical instrument 10 is shown generally and includes a housing 20, a handle assembly 30, a trigger assembly 70, a rotating assembly 80, and an end effector assembly 90, such as, without limitation, a forceps or hemostat, which mutually cooperate to grasp, seal, and/or divide tubular vessels and vascular tissue. As shown, handle assemblies 30 of instrument 10 are of the pistol grip-type, however, any suitable type of handle is envisioned within the scope of the present disclosure. The handle assembly 30 offers a surgeon a gripping position from which to grasp instrument 10 and to transmit a clamping pressure to end effector assembly 90. Instrument 10 includes a shaft 12, which has a distal end 14 configured to mechanically engage end effector assembly 90, and a proximal end 16 configured to mechanically engage housing 20.

[0030] As depicted in FIG. 1, shaft 12 of instrument 10 is relatively elongated. The relatively elongated shaft 12 of instrument 10 enables instrument 10 to be used in performing endoscopic surgical procedures. Shaft 12 may alternatively have a shorter, or longer, shaft than that shown in FIG. 1, which may be desirably utilized in various endoscopic and/or open surgical procedures. Rotating assembly 80 is attached to a distal end of housing 20 and is rotatable in either direction about a longitudinal axis of the shaft 12. In some embodiments, rotating assembly 80 is rotatable approximately 180 degrees in either direction about a longitudinal axis of the shaft 12. Rotation of rotating assembly 80 correspondingly rotates jaw assembly 90 about the longitudinal axis of shaft 12. In some embodiments, as seen in FIGS. 2 and 3, shaft 12 is bifurcated at distal end 14 thereof to form ends 14a and 14b, which are configured to receive jaw assembly 90.

[0031] Instrument 10 further may include an electrical cable 60 extending from housing 20 which couples instrument 10 to a source of electrosurgical energy, e.g., a generator (not explicitly shown). In some embodiments, a source of electrosurgical energy (not explicitly shown), and/or a power source, such as without limitation, a rechargeable battery (not shown), may be included within instrument 10, e.g., within the housing 20 thereof.

[0032] Handle assembly 30 includes a first handle 50 and a second handle 40. Second handle 40 is selectively movable about a pivot (not shown) from a first position in spaced relation relative to first handle 50 to a second position in closer proximity relative to first handle 50 which imparts movement of jaw members 210 and 220 relative to one another, e.g., from an open to closed position about tissue. As shown in greater detail in FIG. 2, jaw assembly 90 is attached to distal end 14 of shaft 12 and includes a pair of opposing jaw members 210 and 220. For illustrative purposes, jaw member 210 may be referred to as an upper jaw member 210 and jaw member 220 may be referred to as a lower jaw member 220. First and second handles 40, 50 are ultimately connected to a drive rod (not explicitly shown) which, together, mechanically cooperate to impart movement of jaw members 210, 220 from an open position wherein the jaw members 210, 220 are disposed in spaced relation relative to one another, to a clamping or closed position wherein, e.g., jaw members 210, 220 cooperate to grasp tissue therebetween.

[0033] Jaw members 210 and 220 are seated within a cavity 18 defined between bifurcated ends 14a and 14b of shaft 12. Jaw members 210 and 220 include mutually corresponding component features which cooperate to permit rotation about a pivot pin 260 to effectively grasp, seal, and/or divide tissue. Jaw members 210, 220 each include a jaw housing 216, 226, an insulative substrate or insulator 214, 224 and an electrically conductive surface or electrode 212, 222. Insulators 214, 224 are configured to securely engage the electrodes 212, 224. This may be accomplished by, e.g., stamping, by overmolding, by overmolding a stamped electrically conductive sealing plate and/or by overmolding a metal injection molded seal plate. Such manufacturing techniques produce a jaw assembly having an electrode 212, 222 which is substantially surrounded by an insulating substrate 214, 224. Insulating substrate 214, 224, electrode 212, 222, and the outer, non-conductive jaw housings 216, 226 are preferably configured to limit and/or reduce many of the known undesirable effects related to tissue sealing, e.g., flashover, thermal spread and stray current dissipation. Alternatively, jaw members 210 and 220 may be manufactured from a ceramic-like material and electrically conductive surfaces 212, 222 coated onto the ceramic-like jaw members 210, 220.

[0034] Electrodes 212, 222 may also include an outer peripheral edge which has a radius and insulators 214, 224 that meet electrodes 212, 222 along an adjoining edge which is generally tangential to the radius and/or meets along the radius. At the interface, electrodes 212, 222 are raised relative to insulator 214, 224.

[0035] Jaw members 210, 220 may be electrically isolated from one another such that electrosurgical energy can be effectively transferred through the tissue to form the seal. Electrodes 212, 222 of jaw members 210, 220, respectively, may be relatively flat to avoid current concentrations at sharp edges and to avoid arcing between high points. In addition, and due to the reaction force of the tissue when engaged, jaw members 210, 220 may be manufactured to resist bending. For example, jaw members 210, 220 may be tapered along the width thereof which is advantageous for two reasons: 1) the taper will apply constant pressure for a constant tissue thickness at parallel, and 2) the thicker proximal portion of jaw members 210, 220 will resist bending due to the reaction of the tissue.

[0036] Jaw members 210, 220 may be curved in order to reach specific anatomical structures. For example, dimensioning jaws 210, 220 at an angle of about 50 degrees to about 70 degrees is preferred for accessing and sealing specific anatomical structures relevant to prostatectomies and cystectomies, e.g., the dorsal vein complex and the lateral pedicles.

[0037] As best seen in example embodiments shown in FIGS. 2 and 3, electrodes 212, 222 include a first, larger contact area 212a, 222a and a second smaller contact area 212b, 222b. Larger contact areas 212a, 222a are arranged in a mutually corresponding configuration with respect to jaw members 210, 220 such that contact area 212a mates with contact area 222a when jaw members 210, 220 are in a closed position, e.g., when grasping tissue therebetween. Similarly, smaller contact areas 212b and 222b are arranged in a mutually corresponding configuration such that contact area 212b mates with contact area 222b when jaw members 210, 220 are in a closed position. During use, the larger contact areas of electrodes 212a, 222a may be used to grasp the patient-side of a vessel and/or the smaller contact areas of electrodes 212b, 222b may be used to grasp tissue, vessels, etc. slated for resection. During a vessel sealing procedure, the larger contact areas of electrodes 212a, 222a enable the delivery of electrosurgical energy at a density sufficient to form a burst-resistant vessel seal on the patient side of the jaws. Conversely, the narrower electrodes 212b, 222b enable the delivery of electrosurgical energy to the resection side of the jaw members 210, 200 to produce a smaller seal.

[0038] In one envisioned embodiment, the size ratio of the larger contact area 212a, 222a to the second smaller contact area 212b, 222b is about 3:1, however, the size ratio may be in a range of about 1.2:1 to about 10:1 and in some embodiments may range up to 100:1 or greater. In some embodiments, the width ratio of the width of the larger contact area 212a, 222a to the second smaller contact area 212b, 222b is about 3:1, however, the width ratio may be in a range of about 1.2:1 to about 10:1 and in some embodiments may range up to 100:1 or greater.

[0039] A conductor 310a electrically couples electrode 212 (which includes wide electrode 212a and narrow electrode 212b) to a source of electrosurgical energy as described hereinabove. Similarly, conductor 310b electrically couples electrode 222 (e.g., wide electrode 222a and narrow electrode 222b) to a source of electrosurgical energy.

[0040] In another aspect, jaw housings 216, 226 include a visual indicator 218a and 218b that is configured to enable a surgeon to readily ascertain jaw member orientation. In the example embodiment depicted in FIGS. 2 and 3, visual indicator 218a includes an intaglio arrowhead icon formed in an outer surface of jaw housing 216 that indicates the position of the wide electrode 212a. Similarly, visual indicator 212b includes an intaglio arrowhead icon formed in an outer surface of jaw housing 216 that indicates the position of narrow electrode 212b. As shown in the drawings, indicators 218a and 218b indicate the wide and narrow electrodes 212a, 212b by using corresponding wide and narrow arrows 218a, 218b. The visual indicators 218a, 218b may include arrows, or may include any other icon to represent the wide and narrow electrodes 212a, 212b, respectively. The design of visual indicators 218a, 218b may include a mnemonic element that enables at a glance intuitive interpretation by the surgeon. Other envisioned indicators include a large circle/small circle, single bar/double bar, pictograph, different colors, and so forth. While not explicitly shown in the figures, visual indicators may be included in lower jaw member 226 to enable a surgeon to identify electrode orientation regardless of the rotated position of the jaw member 216, 226. Additionally or alternatively, visual indicators 218a, 218b may be formed by any suitable marking technique, e.g., in raised relief, laser etching, stamping, molding, machining, pigment, ink, dye, overmolding, and the like. Additionally or alternatively, visual indicators 218a, 218b may be positioned on shaft 12 and/or rotating assembly 80 as long as they correspond to jaw member orientation.

[0041] As seen in FIGS. 2 and 3, in order to achieve a desired gap range (e.g., about 0.001 to about 0.006 inches) and apply a desired force to seal the tissue, at least one jaw member 210 and/or 220 includes one or more stop members 239 that limit the movement of the two opposing jaws 210, 220 relative to one another. Each stop member 239 is made from an insulative material and is dimensioned to limit opposing movement of jaw members 210, 220 to within the above gap range.

[0042] A knife channel 215 may be defined through the center of jaw member 220 such that a knife 305 having a distal cutting edge 306 may cut through the tissue grasped between jaw members 210 and 220 when jaw members 210 and 220 are in a closed position, as illustrated with reference to FIGS. 6A and 6B. Details relating to the knife channel 215, knife 305, trigger assembly 70, and a knife actuation assembly associated therewith (not explicitly shown) are explained in limited detail herein and explained in more detail with respect to commonly-owned U.S. Pat. Nos. 7,156,846 and 7,150,749 to Dycus et al.

[0043] Housing 20 is formed from two housing halves that engage one another via a series of mechanical interfaces to form an internal cavity for housing the internal working components of instrument 10. For the purposes herein, the housing halves are generally symmetrical and, unless otherwise noted, a component described with respect to a first of the housing halves will have a similar component which forms a part of a second of the housing halves.

[0044] As mentioned above, first handle 50 and second handle 40 of handle assembly 30 cooperate with one another and with housing 20 to activate a first mechanical linkage (not shown) which, in turn, actuates a drive assembly (not shown) for imparting movement of opposing jaw members 210, 220 relative to one another to grasp tissue therebetween.

[0045] Handle assembly 130 further includes a trigger assembly 70 that cooperates with a knife actuation assembly (not explicitly shown) which enables the extension of knife 305 from a first, proximal, position as depicted in FIG. 6A, to a second, distal position as depicted in FIG. 6B to sever tissue grasped between jaw members 210, 220. Knife 305 travels within knife channel 215 formed within jaws 210, 220. In an embodiment, trigger assembly 70 may include a lockout (not explicitly shown) that inhibits actuation of knife 305 while jaws 210, 220 are in an open position.

[0046] As discussed above, by controlling the intensity, frequency and duration of the electrosurgical energy applied to the tissue, the surgeon can cauterize, coagulate, desiccate, seal and/or simply reduce or slow bleeding. In addition, the disclosed instrument may be operated in one of a plurality of polarity configurations to achieve specific surgical objectives. For example, in a vessel sealing configuration, electrodes 212a and 212b (associated with upper jaw member 210) have a positive polarity (e.g., active electrodes) while electrodes 222a and 222b (associated with lower jaw member 220) have a negative polarity (e.g., return electrodes.) In this generally bipolar configuration, blade 305 is electrically deactivated and severs tissue by physically cutting tissue (e.g., vessel) held between jaws 210, 220. Additionally or alternatively, electrosurgical energy is delivered to a vessel grasped between jaws 210, 220 to effectuate the sealing of the vessel.

[0047] In another configuration adapted for cutting, blade 305 is electrically coupled to a source of electrosurgical energy to form an active (e.g., positive) electrode. Electrodes 212a, 212b, 222a, and 222b are configured as a negative, or return, electrode.

[0048] During use, blade 305 effectuates cutting via cutting edge 306 and/or the electrosurgical cutting energy delivered between blade 305, cutting edge 306, and electrodes 212a, 212b, 222a, and 222b.

[0049] In yet another embodiment depicted in FIGS. 4 and 5, a jaw assembly 290 includes an upper jaw member 310 and a lower jaw member 320. Upper jaw member includes an electrode array 312 having two independent electrodes 312a and 312b. Electrode 312a has a greater surface area than the narrower electrode 312b. Correspondingly, lower jaw member 320 includes a electrode array 322 having two independent electrodes 322a and 322b, wherein electrode 322a has a greater surface area than the narrower electrode 322b. As can be appreciated, electrode arrays 312 and 322 are arranged in a mutually corresponding configuration wherein electrode 312a mates with electrode 322a, and electrode 312b mates with electrode 322b, when the jaw members 310 and 320 are in a closed configuration.

[0050] Each of the four electrodes 312a, 312b, 322a, and 322b are independently coupled to one or more sources of electrosurgical energy. As seen in FIG. 5, electrode 312a is coupled to a source of electrosurgical energy by a conductor 410a, and electrode 312b is coupled to a source of electrosurgical energy by a conductor 411a. Electrodes 322a and 322b are coupled to a source of electrosurgical energy by conductors 410b and 411b, respectively. In an envisioned embodiment, electrodes 312a, 312b, 322a, and 322b and knife 405 may be independently selectively assigned to a positive or negative polarity (e.g., designated as an active or return electrode.) In this embodiment a total of 32 electrode configurations are available to the surgeon.

[0051] For example, and without limitation, wide electrodes 312a and 322a may be configured in a bipolar arrangement to facilitate vessel sealing on the patient side. On the resection (narrow electrode) side, blade 405 may be configured as an active (+) electrode while narrow electrodes 312b and 322b are configured as a return () electrode.

[0052] In another embodiment, electrodes may be alternatively or sequentially energized, either individually or in combination, to achieve effectively simultaneous cutting, coagulating, sealing, etc. In another non-limiting example, a source of electrosurgical energy may be configured to provide, during a first time period, vessel sealing energy to a first pair of electrodes 312a and 322a; during a second time period, the source of electrosurgical energy provides coagulation energy to a second pair of electrodes 312b and 322b; and during a third time period, the source of electrosurgical energy provides cutting energy, e.g., sending positive cutting energy to knife 405 and receiving negative cutting energy at electrodes 312a, 322a, 312b, and 322b. The time periods may be of any duration, however it is envisioned that a time period may have a duration of about 0.001 second to about 0.1 second, and continue in round robin fashion during activation (e.g., while activated by the surgeon.) Various electrode combinations, energy profiles, and sequences thereof may be specified, modified, and/or stored for later recall and use by a surgeon.

[0053] FIG. 7 illustrates another embodiment of an electrosurgical instrument 400 in accordance with the present disclosure. Instrument 400 has a generally scissors-like or hemostat-like structure suitable for use in open surgical procedures. Instrument 400 includes elongated shaft portions 440 and 450 each having a proximal end 441 and 451, respectively, and a distal end 442 and 452, respectively. The instrument 400 includes an end effector assembly 490 which is operably coupled to distal ends 442 and 452 of shafts 440 and 450, respectively. The end effector assembly 490 includes pair of opposing jaw members 410 and 420 which are pivotably connected about a pivot pin 430. The two opposing jaw members 410 and 420 of the end effector assembly 490 are pivotable about pin 430 from the open position to the closed position for grasping tissue therebetween. Jaw members 410 and 420 include asymmetrical electrodes (not explicitly shown) arranged as described hereinabove that may be coupled to a source of electrosurgical energy by cable assembly 460. In some embodiments, a source of electrosurgical energy and/or a power source may be included in instrument 400 for wireless use. Instrument 400 may include at least one handswitch 480, which may be a slide switch or a pushbutton switch, that is adapted to activate the delivery of electrosurgical energy to tissue. Instrument 400 may additionally or alternatively include a knife actuator 470 that is adapted to actuate a knife (not shown) for dividing tissue grasped between jaws 410 and 420.

[0054] While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.